- Cambia Health Solutions, Inc (Portland, OR)
- …and application, Medicare /CMS regulations and applicability in administering the Medicare Product, and health care coding and payment systems (such ... and cross-functional projects.General Functions and OutcomesResponsible for delivering high quality pharmacy clinical services for Medication Benefit Management.May be… more
- ProKatchers (Bowling Green, NY)
- …and audit medical charts for compliance with a focus on HEDIS, QARR, Medicare Advantage Star measures and quality improvement activities. This position will ... Position: HEDIS Quality Reviewer/ Clinical Quality Reviewer Duration:...to the support and training of physicians on proper coding and medical record documentation practices to support improvement… more
- Atrium Health (Charlotte, NC)
- …is warranted per escalation guideline. Works with other departments such as coding , corporate compliance, quality , and finance to support Corporate Goals. ... a key subject matter expert for clinical documentation and risk adjustment coding within the enterprise. This position focuses on priorities for Enterprise… more
- AdventHealth (Altamonte Springs, FL)
- … Coding Clinic(R), CMS guidelines, NCCI guidance, etc. . Provides outcomes of coding quality audit reviews with leadership . Maintains current knowledge of ... : . Five (5) years of inpatient or outpatient coding or Coding Quality Auditor...coding certificate program or associate degree in HIM field **LICENSURE, CERTIFICATION OR REGISTRATION REQUIRED:** + Certified … more
- Penn Medicine (Radnor, PA)
- …needed Certification Requirement: Certified Professional Coder - CPC (AAPC) Summary: + The Coding Quality Specialist will review coded medical records for ... or documentation variances. Research, review and respond to coding and coding quality issues...+ Bachelor's Degree in HIM, Healthcare or Other related field (Required) + 2+ years coding medical… more
- Avispa Technology (Dallas, TX)
- Coding Quality Specialist 31414347 A leading children's medical institution is seeking a Coding Quality Specialist. The successful candidate will be ... nationally recognized organization ie AAPC, AHIMA (must provide proof of PPE/internship hours) Coding Quality Specialist Pay and Benefits: * Hourly pay: $20/hr *… more
- Somatus (Mclean, VA)
- Overview The Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the organization's Risk Adjustment Programs to optimize ... ensure program compliance with governing bodies' regulations, including the Center for Medicare and Medicaid Services. This role will partner with leadership to… more
- Penn Medicine (Philadelphia, PA)
- …coding professional services in an academic medical setting Education Specialization: HIM, Medical Coding or related field We believe that the best care for ... to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means… more
- Beth Israel Lahey Health (Burlington, MA)
- …Physician Based through AHIMA) Experience: 1-2 years of experience in billing, coding , denial management environment related field . Skills, Knowledge & ... America) Identifies, reviews, and interprets third party payments, adjustments and coding denials for all professional services. Reviews provider documentation in… more
- Highmark Health (Columbus, OH)
- …members to optimize data collection and review, provider education and outreach, and coding quality .20% + Develops and presents process improvement and training ... Act (ACA) through Hierarchical Condition Category (HCC) coding , medical coding , clinical terminology and anatomy/physiology, Centers for Medicare and… more
- Highmark Health (Columbus, OH)
- …, medical coding , clinical terminology and anatomy/physiology, and Centers for Medicare and Medicaid Services (CMS) coding guidelines. Works closely with ... team members, and leadership to identify and deliver high quality and accurate risk adjustment coding . Supports all Remote Patient Monitoring (RPM) risk… more
- Highmark Health (Columbus, OH)
- …not limited to Hierarchical Condition Category (HCC) Coding , medical coding , clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid ... , Compliance, partners at Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding . Supports all Remote Patient… more
- Covenant Health Inc. (Knoxville, TN)
- Overview Coding Educator Full time, 80 hours per pay period, Day shift Covenant Medical Group is Covenant Health's employed and managed medical practice ... to the organization's management and staff and may coordinate requested coding investigations. Responsible for education and training for all Covenant coders,… more
- Covenant Health Inc. (Knoxville, TN)
- …to ensure compliance. + Performs research and analysis of ICD-10 and ICD-10-PCS coding to ensure compliance with Medicare , Medicaid guidelines and other ... Employer. Position Summary: Performs or reviews complex level internal coding audit work for i npatient accounts. Work involves...coders. Serves as a resource to coders, CDI staff, Quality and Case Managers, Decision Support and physician office… more
- Iowa Department of Administrative Services (Des Moines, IA)
- …of appropriate system edits to prevent improper payment of claims; monitoring coding quality and productivity metrics; and implementing improvement initiatives. ... working to modernize and innovate solutions to improve the quality of life and health outcomes for the state's...given to candidates with: Bachelor's degree in health care field ; CMS ICD-10 and DRG coding experience;… more
- Sutter Health (Sacramento, CA)
- …degree or diploma._ Bachelor's: Business Administration, Healthcare (RHIT) or related field **CERTIFICATION & LICENSURE:** CCS-Certified Coding Specialist OR ... Overview:** Leads program development, compliance integration, documentation, and data quality , implementation, and guidance for the Sutter Health system. Provides… more
- Intermountain Health (Broomfield, CO)
- …questions, as needed. Performs coding at a complex inpatient hospital coding complexity, such as Medicare and Medicaid charts with extended length ... of new associates within the departments. Monitors and performs quality assurance. Performs coding audits on coders...Associate Degree in Health Information or in a related field required Certified Coding Specialist (CCS) credential… more
- Cleveland Clinic (Cleveland, OH)
- …to coding staff. Conducts coding reviews and training programs to assure coding quality . Develops all training materials and coding aids for both ... coding conventions/guidelines, ICD-10-PCS coding convention/guidelines, CPT/HCPCS coding conventions/guidelines, modifiers, and Medicare prospective payment… more
- UCLA Health (Los Angeles, CA)
- …can do all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is ... audits with the compliance officer and the manager of coding and education. The Assistant Director of Risk Adjustment...Administration, Public Health, Finance, Business Analytics, or a related field or equivalent experience * Six or more years… more
- Hawaii Pacific Health (Honolulu, HI)
- …training, or related experience. **Preferred Qualifications:** Bachelor's degree in a health-related field . Medicare coding and billing auditing experience. ... relevant experience and training, as well as internal peer equity. **Position** Coding Auditor - Compliance **Category** Quality **Employment Type** Employee… more
